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No normal return for West Norfolk dentistry as concerns expressed over PPE and financial strain

Dentistry continues to be disrupted by the coronavirus with health officials warning of a "skeleton service" as some West Norfolk practices reopen for emergency procedures today.

And bosses at a Downham dental practice have told the Lynn News they are “not in a position to reopen” today due to being unable to access PPE.

It comes after the British Dental Association (BDA) said there would be no return to ‘business as usual’ for dentistry despite the go-ahead from the government.

While over 60 per cent of practices in England expect to reopen to some level by the end of June, major constraints will remain on the service according to the British Dental Association (BDA)
While over 60 per cent of practices in England expect to reopen to some level by the end of June, major constraints will remain on the service according to the British Dental Association (BDA)

A key concern for some practices including Priory Dental Care in Downham has been surrounding PPE shortages needed to provide face-to-face care.

Marie Giles, practice manager at Priory Dental Care, said: “We're not in a position to reopen today (Monday, June 8) due to not being able to get the additional PPE required to keep both our staff and our patients safe.

"As a dental profession, we were only made aware of the government’s announcement for reopening at the same time as the public.

“We have had to invest a considerable sum of money making changes to the practice in order to comply with social distancing measures and additional cross infection control needs.

“The PPE that we have be able to source, has also considerably increased in price, compared to before lockdown. This has put an extra financial strain on the business, at an already difficult time.

“However, the safety of patients and staff are paramount.”

She added that once the practice is in a position to reopen, there will be “very limited” number of patients who can be seen in one day.

In line with the chief dental officer’s guidelines, the practice will be adopting a phased return, starting with urgent emergency treatments.

Mrs Giles believes it will be several months before normality returns with telephoning triaging and an advice service continuing for patients at the moment. This has been in place since the practice closed on March 25.

Other practices have reopened today including Brooklyn House Dental clinic in Fakenham who are prioritising the first appointments for patients with urgent care needs.

The practice’s opening hours have been extended to see as many patients as possible while also ensuring extra time is allowed for cleaning between appointments. Clinicians will also be running virtual consultations to reduce face-to-face appointments where possible.

Meanwhile, the Dental Practice on Stonegate Street in Lynn is only providing emergency dental care at the moment due to the coronavirus.

A spokeswoman for the practice said this covers trauma, swelling and pain for those who are not self-isolating and not in the high-risk category.

Patients calling the Kings Lynn Dental Access Centre, based on King Street, are currently receiving the following message: "Currently we are unable to see patients face-to-face, our practice is closed. Telephones are still being answered off site and advice being given between the hours of 8.30am to 12.30 and 1.15 to 4.30pm Monday to Friday, excluding Bank Holidays."

The recorded message adds: "It is also worth noting that any dentist is able to complete triage so please do try your local general dental practitioner."

Those who have a facial swelling or need general advice are asked to wait for a receptionist, but are warned of long waiting times.

The NHS has emphasised treatments offered may vary from practice to practice depending on staff and equipment available.

For many practices, the reopening will be phased in gradually as they undertake the work required to prioritise the safety of patients and staff.

Steve Williams, a dental surgeon and chief executive officer of Together Dental Downham Market, said patients will not be allowed to turn up to the practice without an appointment, as initially they will be triaged by the dental team. If an appointment is essential, patients will be prioritised by their need.

Mr Williams said: "Due to social distancing measures we will need to limit the numbers of patients in the practice at the same time, this will severely reduce the number of patients that can be seen on a daily basis.

"In addition if an aerosol is generated during treatment, the surgery will need to remain unoccupied for one hour before extensive cleaning commences.

"We will be very limited to the number of treatments we can initially perform, however we hope to have this in place within the next two weeks."

The practice, located on Downham High Street, is still waiting for a PPE delivery despite ordering it six weeks ago. They are also awaiting for oxygen cylinders to be returned, which will delay the practice from reopening.

Mr Williams continued: "We will continue to offer advice to patients that call the practice. We have been working hard to train all the team on the new procedures and so, as soon as the oxygen is returned, we will be able to see the most in need patients.

"The practice doors will remained closed and patients will be seen by appointment only."

Patients must contact their usual dental practice by phone or email if they need dental care and will then be given advice or offered an appointment, if appropriate.

West Norfolk county councillor Alex Kemp has raised concerns over accessibility to NHS dental services being lower than the rest of the East of England.

She said: "People’s general health is being put at risk as they cannot access dental care even if they are in dire straits.

"Health outcomes will worsen as preventative dental services have come to a standstill.

"More children will be going to the Queen Elizabeth Hospital for tooth extractions because of decay. This pressure on acute services during lockdown needs to be avoided. The new normal should not be about poorer healthcare.

"We do not want dentists to go out of business if they are not able to operate productively."

The BDA has said its research shows a little over a third (36 per cent) of practices within the country will be reopening today, with the majority (over 60 per cent) of practices estimating they will be able to treat less than a quarter of the patient numbers they saw before the pandemic.

However, Mr Williams of Together Dental Downham believes the BDA survey overestimates the number of patients that will can treated at the moment. He said the figure is more like 10 per cent instead of the 25 per cent stated.

The BDA has called for immediate clarification on key worker status for dental team members, and action on PPE supplies from the government.

Dental practices are among the only businesses on the high street still paying business rates.

Mick Armstrong, chairman of the BDA said: “Anyone expecting dentistry to magically return on Monday will find only a skeleton service.

“Those practices reopening now face fewer patients and higher costs and will struggle to meet demand.

“Dentists returning to work still lack the support offered to our neighbours on the high street, and even clarity on key worker status when it comes to childcare.

“Ministers must change tack if dentistry is going to survive the new normal."

Rachel Webb, director of primary care and public health for NHS England and NHS Improvement in the East of England, said: “It’s great news for patients that further dental practices will start to open from Monday, although practices will need to prioritise patients with the most urgent needs first.

“Practices will look quite different, as measures have been put in place to provide a safe environment for dental services.

"These precautions will mean that clinicians will not be able to work as quickly as usual, and we are grateful to patients for their understanding and cooperation while we move to a more routine level of dental and hygiene care.”

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